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Normal;}{\s1\keepn\widctlpar\adjustright \b\lang2057\cgrid \sbasedon0 \snext0 heading 1;}{\*\cs10 \additive Default Paragraph Font;}}{\info{\title Equal Opportunities Questionairre Form - rECOrd}{\subject Equal Opportunities Questionairre Form - rECOrd}
{\author Steve J. McWilliam}{\keywords form, equal, opportunities, survey, question, questionairre, questionnaire, record, cheshire, mcwilliam, steve, disability, disabilities}{\operator C.J. Hancell & S.J.  McWilliam}{\creatim\yr2000\mo12\dy20\hr8\min50}
{\revtim\yr2000\mo12\dy20\hr8\min50}{\printim\yr2000\mo12\dy19\hr14\min1}{\version2}{\edmins1}{\nofpages1}{\nofwords312}{\nofchars1782}{\*\manager Steve J. McWilliam}{\*\company rECOrd}{\*\category Form}{\nofcharsws2188}{\vern89}}
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EQUAL OPPORTUNITIES
\par }\pard\plain \qj\widctlpar\adjustright \fs20\lang2057\cgrid {\fs16 
\par }{\b rECOrd}{\i  - The}{ }{\b Biodiversity Information Service}{\i  for Cheshire, Halton, Warrington and Wirral}{
 aims to be an equal opportunities employer.  To help assess our success in this we need to gather information on each applicant.  This information is required for monitoring purposes.  Could we therefore ask you to complete the form below:
\par }{\fs16 
\par }{\b Gender:     Male  }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{\b      Female  }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{\b \tab   \tab \tab \tab Age______
\par }{\b\fs16 
\par }{\b ETHNIC ORIGIN SURVEY
\par }{Please look at the descriptions of race or ethnic origin listed below and tick one box:
\par }{\fs16 
\par }{Afro-Caribbean\tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par African\tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Asian\tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par European (inc. UK & Irish origin)\tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par 
\par Other (please specify):  }{\b ______________________________________
\par }{
\par }{\b DISABILITY  SURVEY
\par rECOrd}{ is committed to the equal opportunity for employment of people with disabilities.  To
 help us achieve our goals it would be helpful if you would provide some information about any disability, or disabilities, you may have.  Please read the list below and tick any boxes which apply to you:
\par }{\fs16 
\par }{Non-disabled\tab \tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Hearing impairment \tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Visual impairment (not corrected by spectacles or contact lenses)\tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Speech impairment\tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Mobility Impairment\tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Physical co-ordination difficulties.\tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par (includes problems of manual dexterity and muscular control)
\par Reduced physical capacity (includes inability to lift, carry or otherwise \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par move everyday objects, debilitating pain and lack of strength, breath, 
\par energy or stamina such as might arise from asthma, angina or diabetes)
\par Severe disfigurement\tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Learning difficulties\tab \tab \tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par  (including the mental inability to perceive the risk of physical danger)\tab \tab 
\par Mental illness (substantial & lasting , (e.g. more than one year))\tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Unknown disability (to be used when disability has not yet been established)\tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par Any other single disability (please describe)\tab \tab \tab \tab \tab }{\fs36 {\field{\*\fldinst SYMBOL 155 \\f "Symbol" \\s 18}{\fldrslt\f3\fs36}}}{
\par 
\par If you have ticked more than one box please state what you consider to be the main disability:
\par 
\par 
\par 
\par }{\b Please contact Steve J. McWilliam at rECOrd (01928) 573697 if there is anything we need to know about your disability in order to offer you a
 fair selection interview, (e.g. do you have a speech difficulty or need a wheelchair accessible interview room?)
\par }}